Bronchitis – Acute

What is acute bronchitis and what are the symptoms?

Acute bronchitis is an infection of the the bronchi – the large airways. Acute bronchitis is common and is usually due to a viral infection. A bacterial infection is a less common cause.

The diagram above shows the sites of a range of respiratory infections. This leaflet just deals with acute bronchitis.

See separate leaflets called ‘Sinusitis – Acute’, ‘Tonsillitis’, ‘Sore Throat’, ‘Laryngitis’, ‘Pleurisy’, ‘Bronchiolitis’, and ‘Pneumonia’ for the other types of infection shown in the diagram.

Note: chronic bronchitis is a separate illness and is not dealt with here. See separate leaflet called ‘Chronic Obstructive Pulmonary Disease’ for information on chronic bronchitis.

What are the symptoms of acute bronchitis?

The main symptom is cough. You may also develop fever, headache, cold symptoms, and aches and pains. Symptoms typically peak after 2-3 days and then gradually clear. However, it commonly takes 2-3 weeks for the cough to go completely after the other symptoms have gone. This is because inflammation in the airways caused by the infection may take some time to settle.

What is the treatment for acute bronchitis?

A main aim of treatment is to ease symptoms whilst your immune system clears the infection. The most useful treatments are:

  • Take paracetamol, ibuprofen, or aspirin to reduce fever (high temperature), and to ease any aches, pains and headaches. (Children aged under 16 should not take aspirin.)
  • Have lots to drink if you have a fever, to prevent mild dehydration.
  • If you smoke, you should try to stop for good. Bronchitis, chest infections and serious lung diseases are more common in smokers.

What about cold and cough remedies?

You can buy many other ‘cold and cough remedies’ at pharmacies. There is little evidence of any impact on the infection, but they may be useful for certain symptoms. For example, a decongestant nose spray may help to clear a blocked nose.

But remember, cold and cough remedies often contain several ingredients. Some may make you drowsy. This may be welcome at bedtime if you have difficulty sleeping with a bronchitis. However, do not drive if you are drowsy. Some contain paracetamol, so be careful not to take more than the maximum safe dose of paracetamol if you are already taking paracetamol tablets.

In March 2009 an important statement was issued by the Medicines and Healthcare products Regulatory Agency (MHRA) which says:

“The new advice is that parents and carers should no longer use over-the-counter (OTC) cough and cold medicines in children under 6. There is no evidence that they work and can cause side effects, such as allergic reactions, effects on sleep or hallucinations.

For 6 to 12 year olds these medicines will continue to be available but will only be sold in pharmacies, with clearer advice on the packaging and from the pharmacist. This is because the risks of side effects is reduced in older children because they weigh more, get fewer colds and can say if the medicine is doing any good. More research is being done by industry on how well these medicines work in children aged 6-12 years.”

Note: paracetamol and ibuprofen are not classed as cough and cold medicines and can still be given to children.

What about antibiotics?

Antibiotics are not usually advised if you are normally in good health. Your immune system can usually clear the infection. Antibiotics do not kill viruses. Even if a bacterium is the cause, antibiotics usually do little to speed up recovery of an acute bronchitis. Antibiotics may even make symptoms worse as some people develop side-effects such as diarrhoea, feeling sick and rashes. Antibiotics may be prescribed if you become more unwell, or if you already have an ongoing (chronic) lung disease. They may also be prescribed if a complication develops such as pneumonia – but this is unlikely to occur if you are otherwise healthy.

What symptoms should I look out for?

Acute bronchitis usually clears without complications. Occasionally, the infection travels to the lung tissue to cause pneumonia. Consult a doctor if any of the following occur:

  • If fever, wheezing or headaches become worse or severe.
  • If you develop: fast breathing, shortness of breath, or chest pains.
  • If you cough up blood or if your sputum (phlegm) becomes dark or rusty coloured.
  • If you become drowsy or confused.
  • If a cough persists longer than 3-4 weeks.
  • If you have recurring bouts of acute bronchitis.
  • If any other symptom develops that you are concerned about.

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